ABSTRACT
Objective:To investigate the efficacy of laparoscopic uterine curettage combined with uterine artery embolization in the treatment of cesarean scar pregnancy (CSP) after type Ⅲ cesarean delivery.Methods:Sixty patients with type Ⅲ CSP who received treatment in Jinxiang Hospital Affiliated to Jining Medical University from January 2017 to October 2019 were included in this study. They were randomly assigned to undergo either laparoscopic uterine curettage alone (control group, n = 30) or laparoscopic uterine curettage combined with uterine artery embolization (observation group, n = 30). The amount of intraoperative blood loss, length of hospital stay, surgical cure rate, time to beta human chorionic gonadotropin (β-HCG) value returning to normal level, and the incidence of postoperative complications were compared. Results:The amount of intraoperative blood loss in the observation group was significantly less than that in the control group [(42.36 ± 15.03) mL vs. (119.52 ± 21.84) mL, t = 15.941, P < 0.05]. Length of hospital stay [(6.51 ± 2.21) days vs. (19.25 ± 3.43) days] and the time to β-HCG value returning to normal level [(16.25 ± 5.02) days vs. (28.02 ± 9.38) days] in the observation group were significantly shorter than those in the control group ( t = 17.102, 6.060, both P < 0.05). There was no significant difference in surgical cure rate between the observation and control groups [96.67% (29/30) vs. 90.00% (27/30), χ2 = 0.268, P > 0.05]. There were no significant differences in the incidence of postoperative fever [63.33% (19/30) vs. 56.67% (17/30)], pain [56.67% (17/30) vs. 46.67% (14/30)], infection [6.67% (2/30) vs. 10.00% (3/30)] and vaginal bleeding [6.67% (2/30) vs. 13.33% (4/30)] between the observation and control groups ( χ2 = 0.278, 0.601, 0.000, 0.185, all P > 0.05). Conclusion:Laparoscopic uterine curettage combined with uterine artery embolization for the treatment of type Ⅲ CSP is superior to laparoscopic uterine curettage alone in terms of intraoperative blood loss, hospital stay, surgical cure rate, time to β-HCG value returning to normal level and safety. Therefore, the combined method is worthy of clinical application.